中小企业保险投保表格-TargetInsurance.PDF

SME BUSINESS INSURANCE APPLICATION FORM Please complete in ENGLISH BLOCK LETTERS and as appropriate. FOR INTERMEDIARY USE Name Producer Code SME.A.201709.003 SECTION A INSUREDS INFORMATION Name of Insured Company Room / Flat Floor Block Building Correspondence Address Street District Contact Person Contact Number Email Address Nature of Business Period of Insurance DD MM YY DD MM YY FROM TO SECTION B INSURED PREMISES INFORMATION Insured Premises Address (if different from Correspondence Address) Room / Flat Floor Block Building Street District Type of Occupancy Office Shop Year of Built Are Insured Premises built of concrete and roofed with concrete, and is in good state of repair? SECTION C PLAN SELECTION 1. CONTENTS / STOCK Sum Insured (HK$) 2. EMPLOYEES’ COMPENSATION Are your employees classified as any one of the following occupation list? Indoor Outdoor (Worldwide) Clerical or Management Staff / Sales /